31.2 Flashcards
loss of consciousness after regional anesthesia for ophthalmic surgery- oversedation
may, or may not be present
loss of consciousness after regional anesthesia for ophthalmic surgery- brainstem anesthesia
likely
loss of consciousness after regional anesthesia for ophthalmic surgery- intravascular injection
likely
apnea after regional anesthesia for ophthalmic surgery- oversedation
may or may not be present
apnea after regional anesthesia for ophthalmic surgery- brain stem anesthesia
likely
apnea after regional anesthesia for ophthalmic surgery- intravascular injection
may or may not be present
cardiac instability after regional anesthesia for ophthalmic surgery- oversedation
may or may not be present
cardiac instability after regional anesthesia for ophthalmic surgery- brainstem anesthesia
likely
cardiac instability after regional anesthesia for ophthalmic surgery- intravascular injection
may or may not be present
seizure activity after regional anesthesia for ophthalmic surgery oversedation
not present
seizure activity after regional anesthesia for ophthalmic surgery brainstem anesthesia
not present
seizure activity after regional anesthesia for ophthalmic surgery intravascular injection
likely
contralateral mydriasis after regional anesthesia for ophthalmic surgery oversedation
not present
contralateral mydriasis after regional anesthesia for ophthalmic surgery brainstem anesthesia
may or may not be present
contralateral mydriasis after regional anesthesia for ophthalmic surgery intravascular injection
not present
contralateral eye block after regional anesthesia for ophthalmic surgery- oversedation
not present
contralateral eye block after regional anesthesia for ophthalmic surgery brainstem anesthesia
may or may not be present
contralateral eye block after regional anesthesia for ophthalmic surgery intravascular injection
not present
epinephrine
a & b adrenergic agonist
systemic effect- hypertension tachycardia cardiac dysrhythmias leads to decrease intraocular pressure and can be used for glaucoma
cyclopentolate
anticholinergic
systemic effect- disorientation, psychosis, convulsion, dysarthria
phenylephrine
a adrenergic agonist
systemic effect- hypertension- 1 drop or 0.05ml of a 10% solution contains 5mg of phenylephrine
scopalamine
anticholinergic
central anticholinergic syndrome
atropine
anticholinergic
systemic effects- central anticholinergic syndrome- xerostomia, anhidrosis
echothiophate- MOA
irreversible cholinesterase inhibitor
echothiophate- systemic effects
prolongation of succinylcholine effects reduction in plasma cholinesterase activity up to 3-7 weeks after d/c
acetazolamide moa
carbonic anhydrase inhibitor
acetazolamide systemic effect
diuresis, hypokalemic metabolic acidosis
timolol-moa
b adrenergic antagonist
timolol- systemic effects
atropine resistant bradycardia, bronchospasm exacerbation of congestive heart failure possible exacerbation of myasthenia graves.
acetylcholine moa
cholinergic agonist
acetylcholine systemic effect
bronchospasm bradycardia hypotension
sentinel events related to the preoperative period as defined by the joint comission
hemolytic transfusion reaction
invasive procedure on the wrong patient wrong site or wrong procedure
prolonged fluoroscopy >1500rads
fire flame or unanticipated smoke heat or flashes during an epidode of patient care
an intrapartum maternal death or severe morbidity
key aims for success in outpatient anesthesia
maintain a predictable environment through critical case and procedure selectivity
promote a culture of diligence and patient safety that exceeds that of the hospital setting
monitor peer reviewed literature and track patient outcomes and experience to develop evidence based best practice
standardize workflow and best practices that leverages predictability to create consistently excellent outcomes for patient families and surgeons
can a physician own an outpatient clinic
no it must be a physician group, hospital, investment group or non physician investors
operating room precautions for laser surgery- preoperative period
arrange surgical drapes to avoid aaccumullation of combustible gases
allow time for flammable skin preparation to dry
moisten gauze and sponges in vicinity laser beam
intraoperative period precautions for laser surgery
alert surgeon and or personnel about ignition risk
assign specific roles to each or member in case of fire
use appropriate laser resistant ett
reduce inspired 02 to a minimum value
replace n20 with air
wait a few minutes after steps 3-5 before activating laser
when do we extubatne t&a
awake-some like to extubatne while patient is still under
nerve blocks do what to patients satisfaction and decrease what post op
increase patient satisfaction and decrease ponv and post op pain
how much versed do we give preop
0.01mg/kg
anxious child
0.25mg/kg
anxious patient the night before and day of take what
2-5mg versed
robinol normal dose
7-15mcg/kg
